Limits...
Combined spinal-epidural anesthesia using a reduced-dose of spinal bupivacaine and epidural top up leads to faster motor recovery after lower extremity surgeries.

Yun MJ, Kwon MY, Kim do H, Lee JW - Korean J Anesthesiol (2014)

Bottom Line: The levels of peak sensory block were similar among the groups (P > 0.05).Motor block recovery to MBS 1 was faster for the SE1 and SE2 groups than for the S group (P < 0.001).The operator's satisfaction scores of the SE2 group were lower than those of the other two groups (P = 0.019).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.

ABSTRACT

Background: The purpose of the present study is to investigate the anesthetic effect of reduced doses of spinal bupivacaine with epidural top ups in comparison with those of spinal bupivacaine and to determine the adequate doses of drugs used during lower extremity surgeries.

Methods: SIXTY ADULT PATIENTS WERE RANDOMIZED TO THREE DIFFERENT TECHNIQUE GROUPS: S group (10 mg of spinal bupivacaine), SE1 group (7.5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml) or SE2 group (5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml). The level of sensory block, modified Bromage motor scores (MBS), systolic blood pressure and heart rate were recorded for 30 min following anesthesia. Peak sensory block height and MBS, time for sensory regression to L1 and motor recovery to MBS 1, side effects and operator's satisfaction were noted.

Results: The levels of peak sensory block were similar among the groups (P > 0.05). For the SE2 group, the regression to the L1 dermatome was faster (P = 0.004) and the maximum MBS was lower (P = 0.001) than that of the other two groups. Motor block recovery to MBS 1 was faster for the SE1 and SE2 groups than for the S group (P < 0.001). The operator's satisfaction scores of the SE2 group were lower than those of the other two groups (P = 0.019).

Conclusions: During combined spinal-epidural anesthesia, 7.5 mg of spinal bupivacaine and epidural 1.5% lidocaine 10 ml produced faster motor recovery than did 10 mg of spinal bupivacaine in patients undergoing lower extremity surgeries.

No MeSH data available.


Related in: MedlinePlus

Changes of motor block. Data is mean ± SD. The modified Bromage motor scores of the SE1 and/or SE2 groups were lower than that of the S group throughout the observation period (P < 0.05). Group S: spinal hyperbaric 0.5% bupivacaine 10 mg, Group SE1: spinal bupivacaine 7.5 mg + epidural 1.5% lidocaine 10 ml, Group SE2: spinal bupivacaine 5 mg + epidural 1.5% lidocaine 10 ml. *,†P < 0.05 compared with Group S. ‡P < 0.05 compared with Group SE2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3926997&req=5

Figure 2: Changes of motor block. Data is mean ± SD. The modified Bromage motor scores of the SE1 and/or SE2 groups were lower than that of the S group throughout the observation period (P < 0.05). Group S: spinal hyperbaric 0.5% bupivacaine 10 mg, Group SE1: spinal bupivacaine 7.5 mg + epidural 1.5% lidocaine 10 ml, Group SE2: spinal bupivacaine 5 mg + epidural 1.5% lidocaine 10 ml. *,†P < 0.05 compared with Group S. ‡P < 0.05 compared with Group SE2.

Mentions: The degree of motor block of the SE1 group was lower than that of the control group at 10, 15 min following combined spinal-epidural anesthesia (P < 0.05). For the SE2 group, the degree of motor block was lower than that of the control group at each observation time point (P < 0.05) (Fig. 2). Recovery of motor block to MBS 1 was faster in the SE1 and SE2 groups than in the S group (P < 0.001) (Table 2). The operators complained of inadvertent movements of the lower limb during surgery in four patients of the SE2 group. With regard to the hemodynamic profile, there were no differences between the three groups (P > 0.05) (Fig. 3, Table 3).


Combined spinal-epidural anesthesia using a reduced-dose of spinal bupivacaine and epidural top up leads to faster motor recovery after lower extremity surgeries.

Yun MJ, Kwon MY, Kim do H, Lee JW - Korean J Anesthesiol (2014)

Changes of motor block. Data is mean ± SD. The modified Bromage motor scores of the SE1 and/or SE2 groups were lower than that of the S group throughout the observation period (P < 0.05). Group S: spinal hyperbaric 0.5% bupivacaine 10 mg, Group SE1: spinal bupivacaine 7.5 mg + epidural 1.5% lidocaine 10 ml, Group SE2: spinal bupivacaine 5 mg + epidural 1.5% lidocaine 10 ml. *,†P < 0.05 compared with Group S. ‡P < 0.05 compared with Group SE2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3926997&req=5

Figure 2: Changes of motor block. Data is mean ± SD. The modified Bromage motor scores of the SE1 and/or SE2 groups were lower than that of the S group throughout the observation period (P < 0.05). Group S: spinal hyperbaric 0.5% bupivacaine 10 mg, Group SE1: spinal bupivacaine 7.5 mg + epidural 1.5% lidocaine 10 ml, Group SE2: spinal bupivacaine 5 mg + epidural 1.5% lidocaine 10 ml. *,†P < 0.05 compared with Group S. ‡P < 0.05 compared with Group SE2.
Mentions: The degree of motor block of the SE1 group was lower than that of the control group at 10, 15 min following combined spinal-epidural anesthesia (P < 0.05). For the SE2 group, the degree of motor block was lower than that of the control group at each observation time point (P < 0.05) (Fig. 2). Recovery of motor block to MBS 1 was faster in the SE1 and SE2 groups than in the S group (P < 0.001) (Table 2). The operators complained of inadvertent movements of the lower limb during surgery in four patients of the SE2 group. With regard to the hemodynamic profile, there were no differences between the three groups (P > 0.05) (Fig. 3, Table 3).

Bottom Line: The levels of peak sensory block were similar among the groups (P > 0.05).Motor block recovery to MBS 1 was faster for the SE1 and SE2 groups than for the S group (P < 0.001).The operator's satisfaction scores of the SE2 group were lower than those of the other two groups (P = 0.019).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea.

ABSTRACT

Background: The purpose of the present study is to investigate the anesthetic effect of reduced doses of spinal bupivacaine with epidural top ups in comparison with those of spinal bupivacaine and to determine the adequate doses of drugs used during lower extremity surgeries.

Methods: SIXTY ADULT PATIENTS WERE RANDOMIZED TO THREE DIFFERENT TECHNIQUE GROUPS: S group (10 mg of spinal bupivacaine), SE1 group (7.5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml) or SE2 group (5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml). The level of sensory block, modified Bromage motor scores (MBS), systolic blood pressure and heart rate were recorded for 30 min following anesthesia. Peak sensory block height and MBS, time for sensory regression to L1 and motor recovery to MBS 1, side effects and operator's satisfaction were noted.

Results: The levels of peak sensory block were similar among the groups (P > 0.05). For the SE2 group, the regression to the L1 dermatome was faster (P = 0.004) and the maximum MBS was lower (P = 0.001) than that of the other two groups. Motor block recovery to MBS 1 was faster for the SE1 and SE2 groups than for the S group (P < 0.001). The operator's satisfaction scores of the SE2 group were lower than those of the other two groups (P = 0.019).

Conclusions: During combined spinal-epidural anesthesia, 7.5 mg of spinal bupivacaine and epidural 1.5% lidocaine 10 ml produced faster motor recovery than did 10 mg of spinal bupivacaine in patients undergoing lower extremity surgeries.

No MeSH data available.


Related in: MedlinePlus